| Organization Name: | BROOKVILLE CENTER FOR CHILDRENS SERVICES INC |
| NPI Number: | 1053558940 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLARD T DERR (CHIEF FINANCIAL OFFICER) |
| Mailing Address: | 100 Red Spring Ln Glen Cove |
| State: | NY US |
| Postal Code: | 115421754 |
| Phone Number: | 5166261075 |
| Fax Number: | 5166263308 |
| NPI Enumeration Date: | 01/14/2009 |
| NPI Last Update Date: | 01/14/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 310500000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Intermediate Care Facility, Mental Illness |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. |